The objective of this Fast Track project is to develop an interactive voice response (IVR) application that will resolve three obstacles hindering the widespread adoption of telephone-based interventions in the healthcare arena. First, the process of creating an IVR campaign is labor-intensive, time-consuming and cost-prohibitive. Second, the collaborative aspect of IVR campaign development is not enabled by currently available IVR systems in which no clear guidelines or resources exist to assist healthcare workers in designing and implementing such campaigns. Third, there is a lack of dedicated IVR systems for use in healthcare, as existing proprietary IVR systems are designed primarily for corporate clients and are thus inadequate for adaptation to health outreach campaigns. Numerous studies have shown that IVR is a particularly effective means of communicating health information to patients with limited English proficiency (LEP) and low functional health literacy (FHL). This project will create a system that is tailored to the needs of healthcare personnel and will significantly reduce the time, cost, and labor requirements of adapting IVR technology to outreach campaigns. Phase I research will evaluate the efficacy and adoptability of a set of sample messages with LEP patients and providers and determine the optimal features of the proposed IVR system. During Phase II, a fully- functional prototype of the IVR system will be developed and evaluated via a pilot study with clinicians and researchers who are experienced in IVR health interventions. Finally, a randomized control trial will be conducted in conjunction with a diabetes management program at a leading New York-based medical institution. Clinical outcomes and qualitative feedback from providers and patients will be assessed according to pre-determined benchmarks. PUBLIC HEALTH RELEVANCE: Interactive Voice Response (IVR) technology offers tremendous potential to enhance public health education efforts and to facilitate enhanced patient communications among populations with limited English proficiency (LEP) and/or low functional health literacy. The proposed VoiceReach++ System, a user-friendly, web-based, automated message-delivery application, will harness health educators'expertise in conducting outreach campaigns, reduce time and costs associated with telephone-based communications, and develop a body of quality-controlled voice messages for dissemination into the community. The multilingual, culturally-appropriate telephone messages housed in the VoiceReach++ System's collaborative clearinghouse will serve to increase LEP patients'health knowledge, appointment attendance, and treatment compliance, improving individuals'ability to manage chronic disease, engage in preventive care practices, and improve overall health outcomes.